Overcoming Ongoing EMR Challenges

The AAFP Seeks Needed Improvement Through Legislative Action

As a practicing Family Medicine physician I was an early adopter of the electronic medical record (EMR) so I have long and personal experience with its advantages and disadvantages. Now, while working with practices across the country to help them transition to an effective Team Care model, I am also keenly aware of the compatibility and integration problems brought about by the plethora of different vendors and systems.

I know I share this EMR frustration with most primary care doctors, so it was particularly gratifying to see the efforts that the American Academy of Family Physicians (AAFP) is now directing toward solving some of the major challenges. The EMR is the sharpest two-edged sword in health care. In the midst of an aging population with multiple chronic diseases, the EMR is a critical tool in keeping vast amounts of data organized and available for competent care. Yet not using this tool appropriately has dramatically weakened the entire industry.

Over the years, the AAFP has actively sought lawmaker assistance to help heal various aspects of our healthcare system. The current resolution presented by the AAFP board calls for members to encourage federal policymakers and CMS to create “significant and compelling incentives and disincentives for all electronic health record vendors to enhance their current EHRs in specific ways, including:

  • Enabling interoperability

  • Adopting a standard format for patient health information

  • Creating a user-friendly interface

  • Providing capacity to facilitate chronic disease management

The obvious precedent for this type of action is, of course, the Medicare and Medicaid EHR Incentive Programs which provide financial payment for the “meaningful use” of certified EHR technology. While that initiative has made some strides toward increasing electronic medical record use and overall effectiveness, the ability of one system to speak to another is vital for the successful exchange of information. Any obstacles in the way of that objective will have to be overcome, especially as we move toward new delivery and payment models.

Without interoperability, the health information system, and in large part our healthcare system itself will remain fragmented.

Leonard M. Finn, MD, an AAFP board delegate from Massachusetts and author of the resolution asked a recent Academy board member audience of more than 100 people if they were happy with their EMR. About four or five individuals raised their hand.

In response, he said that in over the decade since they came into relatively common use, “Electronic medical records still fail to help us do what we want them to do – provide a truly higher level of care for our patients. No bank, no airline, no major manufacturing concern would tolerate the quality of the software that most of us have to work with. In particular, interoperability and standard formats for patient health information should have been present when EMRs first came on the market.”

We can’t change that past, but we have a good shot at the future. Our hope now is that the problems of healthcare information exchange, which Dr. Finn mentions, can be rectified as lawmakers listen to our combined voices. Please join with the AAFP in helping to move this initiative forward.